<%@ include file="../../../include/inc_topo.jsp"%>
</head>
<body>
	<%@ include file="../../../include/inc_menu.jsp"%>
	<div class="contact">
		<div class="contact_info">
			<h2>get in touch</h2>
			<div class="map">
				<iframe width="100%" height="250" frameborder="0" scrolling="no"
					marginheight="0" marginwidth="0"
					src="https://maps.google.co.in/maps?f=q&amp;source=s_q&amp;hl=en&amp;geocode=&amp;q=Lighthouse+Point,+FL,+United+States&amp;aq=4&amp;oq=light&amp;sll=26.275636,-80.087265&amp;sspn=0.04941,0.104628&amp;ie=UTF8&amp;hq=&amp;hnear=Lighthouse+Point,+Broward,+Florida,+United+States&amp;t=m&amp;z=14&amp;ll=26.275636,-80.087265&amp;output=embed"></iframe>
				<br>
				<small><a
					href="https://maps.google.co.in/maps?f=q&amp;source=embed&amp;hl=en&amp;geocode=&amp;q=Lighthouse+Point,+FL,+United+States&amp;aq=4&amp;oq=light&amp;sll=26.275636,-80.087265&amp;sspn=0.04941,0.104628&amp;ie=UTF8&amp;hq=&amp;hnear=Lighthouse+Point,+Broward,+Florida,+United+States&amp;t=m&amp;z=14&amp;ll=26.275636,-80.087265"
					style="color: #777777; text-align: left; font-size: 13px; font-family: 'Source Sans Pro', sans-serif;">View
						Larger Map</a></small>
			</div>
		</div>
		<div class="contact-form">
			<h2>Cadastro de Cliente</h2>
			<form method="post" action="contact-post.html">
				<div>
					<span><label>Nome</label></span> <span>
					<input name="nomeCliente" type="text" class="textbox" required name=nomeCliente></span>
				</div>
				<div>
					<span><label>E-mail</label></span> <span><input
						name="emailCliente" type="text" class="textbox" required name=emailCliente></span>
				</div>
				<div>
					<span><label>Rua</label></span> <span><input
						name="ruaCliente" type="text" class="textbox" required name=ruaCliente></span>
				</div>
				<div>
					<span><label>Cidade</label></span> <span><input
						name="cidadeCliente" type="text" class="textbox" required name=cidadeCliente></span>
				</div>
				<div>
					<span><label>Bairro</label></span> <span><input
						name="bairroCliente" type="text" class="textbox" required name=bairroCliente></span>
				</div>
				<div>
					<span><label>Estado</label></span> <span><input
						name="estadoCliente" type="text" class="textbox" required name=estadoCliente></span>
				</div>
				<div>
					<span><label>Login</label></span> <span><input
						name="loginCliente" type="text" class="textbox" required name=loginCliente></span>
				</div>
				<div>
					<span><label>Senha</label></span> <span><input
						name="senhaCliente" type="text" class="textbox" required name=senhaCliente></span>
				</div>

				<div>
					<span><input type="submit" class="" value="Submit us"></span>
				</div>
			</form>
		</div>
		<div class="clear"></div>
	</div>
	</div>

</body>
<%@ include file="../../../include/inc_rodape.jsp"%>